title: Examination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction.
abstract: Electronic test ordering, via the Electronic Medical Record (EMR), which incorporates computerised provider order entry (CPOE), is widely considered as a useful tool to support appropriate pathology test ordering. Diagnosis-related groups (DRGs) are clinically meaningful categories that allow comparisons in pathology utilisation by patient groups by controlling for many potentially confounding variables. This study used DRG data linked to pathology test data to examine changes in rates of test ordering across four years coinciding with the introduction of an EMR in six hospitals in New South Wales, Australia. This method generated a list of high pathology utilisation DRGs. We investigated patients with a Chest pain DRG to examine whether tests rates changed for specific test groups by hospital emergency department (ED) pre- and post-EMR. There was little change in testing rates between EDs or between time periods pre- and post-EMR. This is a valuable method for monitoring the impact of EMR and clinical decision support on test order rates.
authors.affiliation: Centre for Health Systems and Safety Research, UNSW, Sydney, Australia.
authors.forename: Elia
authors.initials: E
authors.lastname: Vecellio
authors.forename: Andrew
authors.initials: A
authors.lastname: Georgiou
authors.forename: George
authors.initials: G
authors.lastname: Toouli
authors.forename: Alex
authors.initials: A
authors.lastname: Eigenstetter
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.forename: Roger
authors.initials: R
authors.lastname: Wilson
authors.forename: Johanna I
authors.initials: JI
authors.lastname: Westbrook
mesh_terms: D002637:Chest Pain / Q000473:pathology*; D003953:Diagnosis-Related Groups; D017598:Efficiency, Organizational; D057286:Electronic Health Records; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D050316:Medical Order Entry Systems; D009517:New South Wales; D010338:Pathology, Clinical; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*